Soft Tissue Mobilization (STM)

A Physical Therapist can do many different types of manual therapy (see here for the different types). One of the specific types of manual therapy is soft tissue work.

Types of Soft Tissue Work Include:

• STM (soft tissue mobilization) or massage
• IASTM (instrument assisted soft tissue mobilization) with the use of a tool
• Cupping
• Stretching
• Dry Needling

STM

Just like In my manual therapy post, I also explain and will again here that STM for a PT is not the same as going to see a massage therapist. 

Instead, when a PT does STM, we focus on one specific area and for different reason other than to feel good and relax. PT’s do soft tissue work to relieve pain and improve the flexibility of the muscle being worked. 

Two types of STM I use in my practice are with fiber and cross fiber. These types are both named for the technique used on the body.

With fiber: I will work the muscle in the direction of the fibers of the muscle. This is more of a relaxation technique. Usually, I will start with this one before going to the cross fiber.

Cross fiber: I will work against the direction of the fibers. Used to decrease the tightness of the muscle and reduce pain.

There are other types of STM including

• edema management (swelling)
• cross friction (scar management). 

Unlike for with and cross fiber, edema and cross friction massage is performed primarily following surgery. I will perform these as often as needed but usually only for about the first 2 weeks post-surgery.

For the edema, the limb is elevated, and massage the massage is performed in a downward motion towards the heart to decrease the swelling.

To improve the mobility of the scar, a PT will perform cross friction from side to side across the scar to break up the adhesions and scar tissue underneath.

A Physical Therapist performs STM for many different reasons and some of those reasons are listed above. It is my belief that this is where patients believe PT’s will do massage. Obviously, some PT’s do, but it is not the only tool in our toolbox.

One specific type of manual therapy is soft tissue work and the other types will be discussed in later posts.